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Individual

JAY MAINTHIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4199 WASHINGTON STREET, SUITE 1, ROSLINDALE, MA 02131
(617) 323-4440
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1015761
MA
207Q00000X
Family Medicine Physician
Primary
3014441
MA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110201935A
MA
Enumeration date
05/11/2021
Last updated
05/11/2026
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